EUS Diagnosis and Endotherapyin a 2 yrsmale child for suspected of acute on chronic pancreatitis

A 2yrs old male child came to us with severe abdominal pain and recent imaging showed cystic area in the pancreas. He was advised by clinicians that nothing can be done for pancreatic disease in children.

EUS showed normal CBD, No evidence of stone or sludge in CBD. Gall Bladder appeared distended but normal.

MPD appeared prominent in head region 4.0 mm with an abnormal course, suggestive of ductal anomaly. A small cystic collection was noted around the uncinate process.

MPD appeared irregular in the body with atrophy of the gland in the body and tail. Pancreas appeared oedematous.

Selective cannulation of MPD was achieved.

Pancreatogram confirmed the EUS finding of early changes of chronic pancreatitis with communicating chronic pseudocyst in the head region.

Pancreatic sphincterotomy was performed.

A communicating chronic pseudocyst a 5 fr single pigtail stent was then placed to ensure ductal decompression.

Child made an uneventful recovery and was sent home the next evening.

EUS revealed MPD appeared prominent in head region 4.0 mm with an abnormal course

A small cystic collection was noted around the uncinate process.

Selective cannulation of MPD

Pancreatogram showed early changes of chronic pancreatitis with communicating chronic pseudocyst in the head region

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About: Endoscopy Asia is one of the Asia's Leading Institute in the Field of Gastroenterology, Hepatology & Endoscopy. Apart from routine diagnostic and therapeutic OGD Scopy, Colonoscopy, ERCP and Endoscopic Ultrasound (EUS), Endoscopy Asia has also acquired the much needed Single Balloon Enteroscope. The founder and director of Endoscopy Asia, Dr. Vipulroy Rathod has been in clinical practice in Mumbai for more than a decade and has the largest individual experience in Advanced Endoscopy and Endoscopic ultrasound in the Indian subcontinent and is the pioneer of Interventional Pancreato-Billiary EUS.